What You Need To Know About Measles
Infectious Disease specialist, Dr. Mia Taormina - Chair of DuPage Medical Group’s Infection Control
Task Force, weighs in on the measles outbreak.
Question: Who is at risk for measles?
Answer: You are at risk for measles if you are an adult or child who has not been fully vaccinated against measles in the past. Adults born before 1957 do not require measles vaccine as they were born during a time of widespread measles and are considered effectively immune due to exposure. Once both doses of MMR are received, the vaccine is 95-99% effective at preventing measles.
Question: What are the symptoms of measles?
Answer: Measles begins with a prodrome of very high fevers (>101F, often much higher), cough, runny nose, and red eyes (conjunctivitis) anywhere from 4-21 days after being exposed to an individual with active measles. These symptoms preceed the telltale rash of measles by up to 4 days. Rash consists of small red spots and begins on the head and travels down the body towards the feet. In rare cases severe symptoms such as mental status changes (encephalitis) and other life threatening conditions may result.
Question: How is measles spread?
Answer: Measles is an airborne virus and can spread swiftly to unvaccinated individuals in close proximity to a source patient. Measles can remain in the air and on surfaces for 2-4 hours before dissipating.
Question: How long is measles contagious?
Answer: Measles is contagious as soon as symptoms present (up to 4 days before the rash is seen) and for 4 full days after the rash completely resolves. An unvaccinaated person who has come in contact with a known measles case must remain quarrantined in their home for 21 days to see if symptoms will develop.
Question: I have heard of recent outbreaks in Disneyland and at a local daycare - is my child at risk?
Answer: There are several cases currently in IL. The health departments are working to notify individuals of possible exposures. If your child is vaccinated, even if they have only had the first vaccine, they have only a very small chance of being susceptible to catching measles. If you have a baby less than 12mo of age who is unvaccinated and has come into contact with a known case of measles, please contact your doctor.
Question: I have heard the measles vaccine is "safe" in babies over 6 months old. Can my baby get vaccinate early? Can my 3 year old get a second dose early?
Answer: There is no current recommendation to vaccinate infants early or to give the 2nd MMR vaccine early. This includes infants currently in a daycare setting. There are special circumstances regarding possible travel with infants to highly populated tourist areas; in these situations you might speak with your pediatrician about early MMR vaccine. Infants traveling overseas should have one dose of MMR. Small children under the age of 6yo should have both doses of MMR vaccine prior to international travel.
Question: Why are there suddenly so many cases of measles when it was nearly eradicated by the year 2000?
Answer: Unfortunately, in recent years, there has been a trend towards not vaccinating children. Society depends on a significant percentage of the population to be vaccinated in order to achieve "herd immunity" so that there are enough vaccinated persons to effectively eradicate the disease. When less and less children are vaccinated, we lose this effective immunity and are at risk for outbreak once again. This is due to some misinformation about vaccine safety. While all vaccines have the potential of side effects, the vast majority are very mild and self-limited. Most clinicians would agree that the risk for a severe illness due to measles is far greater than the risk of a severe adverse reaction to the MMR vaccine.
Question: I heard some children who recieved the MMR vaccine became autistic?
Answer: This information was published in The Lancet many years ago and has since been fully refuted and retracted. The physician responsible for this study has lost his privilege of practicing medicine. There is no cause and effect relationship between the MMR vaccine and autism. Unfortunately the aftermath of this debunked study has been severe and there are still those who believe this misinformation.
Question: Who can be vaccinated against measles?
Answer: Any child or adult over the age of 12mo who does not have a compromised immune system may be vaccinated. MMR vaccine is a live attenuated vaccine so patients with certain cancers and HIV, for example, are not able ro receive the vaccine. This is why it is so important that all healthy individuals are vaccinated as those unable to be vaccinated could become seriously ill if they were to contract measles.
Question: How is measles treated?
Answer: Measles is treated supportively by allowing the symptoms to subside. Good hydration and as needed tylenol and ibuprofen for fevers as well as rest and recovery. The best treatment, however, is prevention through vaccination.
Question: How do I know if I was vaccinated?
Answer: If you are an adult born after 1957 and are unsure of your vaccine status, your doctor can check a blood test for immunity to the measles virus. You should check with your insurance company as to what the cost of this test may be. If you are found to be immune, no further action is necessary. If you do not show evidence of immunity, you can receive MMR vaccine which is given in two separate injections at least 28 days apart.
Questions: I decided not to vaccinate my son or daughter and now that measles is widespread I have changed my mind, what should I do?
Answer: It is not too late to receive MMR vaccine. Please contact your pediatrician to begin a "catch-up" vaccine schedule to immunize your child against measles.
Questions: Who should I call if I have further questions or if I think I have symptoms of measles?
Answer: You can speak with a representative at your doctor's office if you have further questions regarding measles. If you think you might have symptoms of measles, DO NOT come to the clinic, urgent care, or hospital. Please call your doctor and he or she will help you with what to do next.
Dr. Mia Taormina is the Chair of DuPage Medical Group’s Infection Control Task Force, in addition to practicing in our Infectious Disease department.